The purpose of the night float rotation at Washington Regional
Medical Center is to provide Upper level residents with a focused experience in
the evaluation and care of a broad range of patients commonly encountered in
all aspects of the hospital setting at night including critical care,
medical/surgical units, pediatrics, nursery and emergency medicine. PGY-II
Residents complete the night float as a 4- week block rotation. PGY-III
residents complete one 2-week block rotation.
Goal I: Demonstrate a working knowledge of ER,critical
care, medical/surgical units, pediatrics, and nursery.
Goal II: Expand upon skills in the ER and the Inpatient
Service.
Goal III: Demonstrate competence with the differential
diagnosis and treatment of common ER visits, critical care, medical/surgical
units, pediatrics, and nursery.
The resident is expected to:
Report Monday through Friday 5:00pm to 7:00am.
Take phone calls after hours from continuity patients of both outpatient
clinics.
Supervise and provide guidance to PGYI residents and medical students
Check out all admissions to the faculty attending on call during the night.
Supervise the PGY-I resident in the Emergency Room/non-urgent care and floor
settings.
Supervise the PGY-I resident procedures as necessary to insure quality patient
care.
Sign out to oncoming Family Medicine senior resident at 6:30 a.m. to 7:00 a.m.
Required to attend one ½ day of clinic on Monday afternoon each week.
Patient Care
Goal
Patient Care: Residents must be able to provide patient care
that is compassionate, appropriate, and effective for the treatment of health
problems and the promotion of health. The Family Medicine Resident is
expected to:
Demonstrate caring and respectful behaviors in patient care.
Establish a foundation of skills in interviewing, informed decision-making, and
the development of treatment plans.
Counsel and educate families, perform physical exams and procedures, and
perform preventative healthcare.
Medical Knowledge
Goal
Medical Knowledge: Residents must demonstrate
knowledge of established and evolving biomedical, clinical
epidemiological and social-behavioral sciences as well as the
application of this knowledge to patient care. The Family Medicine
Resident should have knowledge of:
Basic sciences in the principles of history taking.
Principles of problem solving.
Technique of basic and advanced cardiopulmonary resuscitation.
Indications for and method of diagnostic procedures including venipuncture,
lumbar puncture, pulse oximetry, and nasogastric intubation,
Indications for subspecialty referral and consultation.
Pathology, physiology, diagnosis, and management of common problems.
Practice- Based Learning and Improvement
Goal
Residents must demonstrate the ability to investigate and evaluate their care of
patients, to appraise and assimilate scientific evidence, and to continuously
improve patient care based on constant self-evaluation and life long
learning. Residents are expected to develop skills and habits to be able
to :
Competencies
Identify and perform appropriate learning activities.
The residents will identify strengths and limits of knowledge by progressive
increases in their knowledge base.
Use information technology to optimize learning.
Objectives
The resident becomes competent in the use of UpToDate, DynaMed, and
journal searches. The resident will learn to utilize a variety of
knowledge sources.
The resident will become
competent in the use of EMR to track patients, recover lab data and
medical reports. The resident will become competent to use the PDA
with Epocrates and 5-Minute Medical Consult.
Systems Based Practice
Goal
Residents must demonstrate an awareness of and responsiveness to the larger
context and system of health care, as well as the ability to call effectively
on other resources in the system to provide optimal health care.
Residents are expected to:
Competencies
Work in interprofessional teams to enhance patient safety and improve patient
care quality.
Objectives
The resident will:
Understand the interaction of ER follow-up and urgent patient issues.
Promote timely notification of referring physicians.
Strive to insure good patient flow while preserving high quality of care.
Practice cost–effective care and advocate for patients within the
system.
Work to control health care costs and allocate resources to provide high
quality care.
Professionalism
Goal
Residents must demonstrate a commitment to carrying out professional
responsibilities and an adherence to ethical principles. Residents are
expected to demonstrate:
Competencies
Compassion, integrity, and respect for others.
Objectives
The resident will:
Receive mentoring by the faculty to teach the understanding of
compassion, integrity, and respect in care of the adult with acute and chronic
problems.
Demonstrate a commitment to carrying out his/her professional
responsibilities
Demonstrate
respect, compassion and integrity and respond to the needs of patients
Demonstrate adherence to ethical principles
Respect and maintain confidentiality of patient information
Show sensitivity and respect to diverse patient populations.
Know when to seek consultation from other appropriate
specialists to either manage or co-manage a patient for optimal care.
Respond to pages and other consultations in a timely manner.
Dictate comprehensive history and physical exams in a timely
manner
Develop respectful, altruistic, ethically sound practice which
is sensitive to culture, age, gender, disability issues.
Interpersonal and Communication Skills
Goal
Residents must demonstrate interpersonal and communication
skills that result in the effective exchange of information and teaming with
patients, their families, and professional associates. Residents are
expected to:
Competencies
Communicate effectively with physicians, other health professionals, and health
related agencies.
Recognize the impact of social, cultural and environmental factors that will
affect the health and well being of patients and their families.
Understand the importance of educating the public about environmental factors
that can adversely affect patients and about development of community programs
that promote health.
Demonstrate an awareness of the importance of physician and patient working as
partners to promote optimal health.
Demonstrate interpersonal and communication skills that result in effective
information exchange with patients, families and colleagues.
Work effectively with others as a member of a healthcare team.
Create therapeutic relationships with patients and the development of listening
skills.
Objectives
The resident will learn appropriate consultation, timely transfers, and other
options of care for acute and chronic problems.
Teaching Methods
Case discussion, evaluation of x-rays and lab results.
Assessment Method
At the conclusion of each resident rotation, the residency
coordinator sends a formative-type, rotation-specific performance evaluation
form to the rotations' supervising physician. When the completed
evaluation is returned, the resident physician and the resident's faculty
advisor review the evaluation and attest to reviewing it by signing/initialing
the form. Next, the program director reviews and attests to the
document. Once all three have reviewed and attested the evaluation, it is
included in the resident's permanent file.
Resident will evaluate the faculty supervising the
rotation anonymously via New Innovations.
Educational Resources
References available at the AHEC Library:
Bennet JC, Goldman L. Cecil textbook of medicine. 21st
ed. Philadelphia, Saunders, 2000 2v.
Fauci A, et al. Harrison's principles of internal medicine. 14th
ed. New York, McGraw-Hill, 1997.
Rakel, RE. Saunders manual of medical practice. 2nd ed.
Philadelphia, Saunders, 2000.
Pfenninger, JL, Fowler GC. Procedures for primary care
physicians. St. Louis, MO, Mosby, 1994.
Behrman RE, et al. Nelson textbook of pediatrics. 16th
ed. Philadelphia, Saunders, 2000.
Sieberry GK. The Harriet Lane handbook: a manual for pediatric
house officers. 15th ed. Mosby, 2000.
Tintinalli JE. Emergency medicine: a comprehensive study guide.
5th ed. New York. McGraw-Hill, 2000.
